High Cholesterol

There are a few things that can lead to high cholesterol: what you eat, how physically active you are, and your genetics. You can’t do anything to change your genetics, but you can make changes to your exercise and eating habits that could help to lower your cholesterol levels.

What is cholesterol?

Cholesterol is a waxy fat-like substance that’s naturally made in your body, by your liver. It’s needed to make hormones and Vitamin D. Cholesterol is also used to make a substance, called bile salts, that helps to digest some of the food you eat.

Two types of cholesterol – HDL and LDL: There are two major types of cholesterol in the body that your health care provider may measure in your blood: HDL and LDL cholesterol. The desirable kind of cholesterol is called HDL cholesterol. Ideally this number should be as high as possible. LDL cholesterol is the more undesirable type of cholesterol so the goal is to keep this number low. Most people who have high cholesterol have too much LDL cholesterol. It is this type of high cholesterol that health care providers are concerned about. Usually, when cholesterol is measured, you receive both the sum of your LDL and HDL levels, as well as what each of those levels is separately.

Do I need cholesterol?

Everyone needs to have some cholesterol in their blood, but having too much LDL can increase the risk of developing heart disease. Keeping your cholesterol levels within the normal range is one way to help prevent disease later in life.

Why do I have high cholesterol?

Sometimes, genes passed down from your family can cause you to have high cholesterol beginning when you are young. This is because your body may make too much cholesterol. Other times, you may have high cholesterol because of what you eat, how active you are, or whether you drink alcohol or smoke.

What foods can increase cholesterol levels?

The cholesterol found in food (dietary cholesterol) is different from the cholesterol found in your body (blood cholesterol). You may have heard the recommendation to avoid dietary cholesterol to help lower blood cholesterol levels. However, recent research shows that dietary cholesterol has minimal, if any, effect on blood cholesterol. Nutrition facts labels still list the amount of cholesterol in a food. If you look at labels you may notice that eggs and meat are two foods that contain cholesterol.

On the other hand, other foods that are high saturated fats and trans fats may increase blood cholesterol levels. Saturated fats are found in animal products that we eat and drink such as milk, cheese, ice-cream, butter, fatty meats like bacon and sausage, poultry with skin, and egg yolks. This does not mean that you need to avoid these foods, just eat them in moderation. Trans fats, which are artificially made by food manufacturers, can show up in foods such as french fries, chips, crackers, muffins, and cookies. Check the nutrition facts label to see if any amount of trans fat is listed and try to avoid foods that contain any if you can. Avoiding foods with “hydrogenated and partially hydrogenated oils” listed on the ingredient list will also ensure that you are not eating any trans fat.

How can I lower my cholesterol?

If you have high cholesterol you can work towards lowering it by maintaining or reaching a healthy weight, exercising, not smoking, and choosing healthy foods and drinks.

Read the Nutrition Facts Label on food products you buy to keep the amount of saturated fat and trans fat in your diet low.

Choose unsaturated fats such as olive oil, canola oil, nuts, seeds, and avocado in place of saturated and trans fats.

Eat more fiber from fruit, veggies, beans and whole grains. Aim for 35-38 grams of fiber per day. Foods with soluble fiber in them grab onto cholesterol in your digestive system and drag it out before it has a chance to get into your blood.

Guys ages 9-18 should get 25-35% of their calories each day from fat. Most fats should be from foods with unsaturated fats (like nuts, fish, and vegetable oils) and with less fats coming from foods with saturated and trans fats (like desserts, fried foods, and meats like bacon and sausage).

What if I don’t want to change what I eat?

It can be overwhelming to think about making changes to the way that you’re used to eating. It’s a good idea to start with small changes that are the easiest to make and then go from there. For example, you could start by eating oatmeal with nuts for breakfast instead of a bagel with butter. Or, you could replace eating meat daily with eating fish a few times per week.

Here’s a chart of other things you can swap out to help lower your cholesterol levels.

Instead of

Eat

Hamburger

Veggie burger

Ice cream

Frozen yogurt

2 slices pepperoni pizza

1 slice vegetable pizza with a side salad

Mayonnaise on your sandwich

Hummus on your sandwich

Butter

Plant-based spreads such as Benecol®, Smart Balance®, or Olivio®

Creamy salad dressing

Oil and vinegar based dressing

Bagel with cream cheese

Oatmeal or high fiber cereal with nuts

Cheese and crackers

Trail mix (nuts and raisins)

Cholesterol is an important type of fat in the body used to make hormones and Vitamin D and to help with digestion. If you have too much cholesterol in your body (high total cholesterol or high LDL cholesterol), adjusting eating habits can be one way to lower your cholesterol and improve your heart health.

If you’re concerned about cholesterol, here’s a tip on how to bring it up with your health care provider: What can I do to lower my cholesterol?

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Young Men’s Health (YMH) is produced by the Division of Adolescent and Young Adult Medicine at Boston Children’s Hospital. The purpose of the website is to provide carefully researched health information to teenage boys and young men.